Death certificate errors in three teaching hospitals of Zahedan, southeast of Iran.

Accurate completion of death certificates is of critical importance for public health policy and statistical purposes. In assessing 936 available death certificates, most contained one or more errors. Minor errors (e.g. absence of time intervals) were more common than major errors (e.g. the use of general terms instead of specific conditions). Providing education, complying with standards established by the World Health Organization, applying quality control of death certificates, and correcting deficient death certificates in the hospitals seem necessary to inform the effectiveness of public health programs, future health policies, quality health planning, and prioritization of health and medical research programs.

Association of Serum Level and DNA Methylation Status of Brain-Derived Neurotrophic Factor with the Severity of Coronary Artery Disease.

New investigations suggest a pivotal role of brain-derived neurotrophic factor (BDNF) in cardiovascular homeostasis. However, no data could indicate the association between BDNF methylation status and the risk of coronary artery disease (CAD). The aim of the present study was to assess the association of BDNF methylation status and its serum level with the severity of CAD. According to the angiography report, a total of 84 non-diabetic CAD patients with at least 50% stenosis in one of the major coronary arteries were selected as the CAD group. For comparison, 62 angiographically proven non-CAD participants were selected as control. Additionally, subjects were categorized according to the Gensini Scoring system. Blood sample was used for genomic DNA isolation. Methylation status of the BDNF gene in exonic region was determined using the MS-PCR method and serum BDNF levels were measured with ELISA. BDNF gene methylation was significantly higher in the CAD group than in the non-CAD group. After adjustment for confounding factors, BDNF gene hypermethylation increases the risk of CAD in the total population (OR = 2.769; 95% CI, 1.033-7.423; P = 0.043). BDNF gene hypermethylation was higher in patients with severe CAD than patients with mild CAD. Additionally, the serum BDNF level was not different from non-diabetic CAD and control groups. Our findings indicate that BDNF hypermethylation was associated with an increased risk of CAD, which may help identify subjects being at the risk of developing CAD. In addition, BDNF hypermethylation shows a significant correlation with the severity of CAD.

Epidemiology, Sociodemographic Factors and Comorbidity for Allergic Rhinitis, Asthma, and Rhinosinusitis Among 15 to 65-year-Old Iranian Patients.

Background: It is well established that upper and lower airways are often clumped together when diagnosing and treating a disease. This study was designed to determine the prevalence of upper and lower airway diseases and to assess the effect of sociodemographic factors on the prevalence and the comorbidity of these disorders. Methods: This cross-sectional population-based study included patients with ages ranging between 15 to 65 years, who were referred to allergy outpatient clinics in various provinces of Iran from April to September 2020. A modified global Allergy and Asthma European Network (GA2LEN) screening questionnaire was filled out by local allergists of the 12 selected provinces in Iran. Information about the patients and sociodemographic factors was also recorded. Statistical analysis was done by univariate statistical analyses and multiple logistic regressions in SPSS software Version 26. Results: Out of 4988 recruited patients, 1078 (21.6%) had the symptoms of allergic rhinitis (AR) and 285 (5.7%) met the criteria of asthma. The prevalence of acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS) was 21.6 % and 22%, respectively. The highest prevalence of AR and ARS was in Tehran with the arateof of 33.9% each. Asthma was more prevalent in Khuzestan (14.2%) and CRS in Baluchestan (57.5%). Our analysis showed that the patients with asthma were most likely to have other allergic diseases as well-CRS (OR = 4.8; 95% CI, 2.02- 5.82), AR (OR= 2.5, 95% CI, 2.10-3), ARS (OR = 1.8; 95% CI, 2.10-3), followed by eczema (OR = 1.4; 95% CI, 1.13-1.67).We found that those individuals with CRS were most likely to have painkiller hypersensitivity (OR= 2.1; 95% CI, 1.21-3.83). Furthermore, smoking has been found more than 1.5 folds in patients with ARS. After adjusting variables, there was no correlation between education, occupation, and ethnicity with the studied diseases. Conclusion: Rhinosinusitis is a common condition among Iranian patients. This study confirmed that inflammation of the upper and lower airways can occur simultaneously. Gender, education, occupation, and ethnicity were found to be irrelevant in the development of either AR, asthma, ARS, or CRS.

What are the intervention goals of women's hookah cessation? A systematic, evidence-based and participatory study.

This Study was designed to answer the question: what are the intervention goals of women for ceasing to smoke. The present research was part of a larger study and was a pioneering systematic research conducted between September 23, 2018 and September 26, 2019 through an intervention mapping in southern Iran among professional hookah Smoking (HS) women. In order to know more about the HS among women, the behavioral and environmental correlates of HS/cessation and the determiners or fundamental causes of these factors were extracted via a systematic review and a local qualitative study. As the results revealed, the expected outcomes of the educational program concerning hookah cessation were achieved. As the realization of these outcomes requires certain changes to the behavioral and environmental dimensions, in the next step, the intervention goals of hookah cessation were identified. As the results showed, four behavioral factors involved in the unhealthy HS behavior were individual HS, Being in the Company of hookah smokers, Visiting tempting and contaminated places and Physical and mental dependence on HS (habit), In addition, four effective environmental factors were found at different interpersonal, organizational, community and policy levels. These include, respectively: recommendation and motivation for cessation by influential figures, care providers' poor inadequate knowledge and skill, Easy acceptance of hookah in society, and the lack of effective rules. Knowledge, awareness, social norms, Motivation to comply, skill and self-efficacy, habit, were among the determining factors of hookah cessation. Employment of a systematic is based on evidence and cooperation and is guided by a assessing the needs of the target population. Such a method can suggest more purposive and relevant intervention goals so as to cease HS. The aim would be to intervene in the purposes of the above-mentioned change, as compared in predetermined interventions, and increase the chances of HS cessation among women.

Pediculosis capitis among school-age students worldwide as an emerging public health concern: a systematic review and meta-analysis of past five decades.

Pediculosis by Pediculus humanus capitis is still an important health issue in school-age students worldwide. Although pediculicidal agents effectively kill head lice, the re-infestation rate is still high. This study was conducted to provide a summary of evidence about the prevalence of pediculosis capitis among school-age students worldwide. Different databases including MEDLINE/PubMed, Scopus, and Web of Science were searched for publications related to pediculosis capitis in school-age students from 1977 to 2020. All peer-reviewed original research articles describing pediculosis capitis among school-age students were included. Statistical heterogeneity of the different years among studies was assessed using the standard chi squared and I2 tests. Due to the significant heterogeneity, a random effect model was adopted to estimate the pooled, continent, and gender-specific prevalence of pediculosis. Two hundred and one papers met the inclusion criteria of this review and entered into the meta-analysis including 1,218,351 individuals. Through a random effect model, the prevalence of pediculosis capitis among school students was estimated as 19% (CI 95% = 0.18-0.20%, I2 = 99.89%). The prevalence of pediculosis capitis among boys was 7% (CI 95% = 0.05-0.10) compared to 19% (CI 95% = 0.15-0.24) in girls. The highest prevalence was in Central and South America (33%, CI 95% = 0.22-0.44, I2 = 99.81%) and the lowest was in Europe (5%, CI 95% = 4-6, I2 = 99.28%). Relatively high pediculosis capitis prevalence among school-age students observed in this study emphasizes the need for implementing screening and prophylaxis tailored to the local context.

The frequency of cross-reactivity with various avian eggs among children with hen's egg allergy using skin prick test results: fewer sensitizations with pigeon and goose egg.

INTRODUCTION AND OBJECTIVES: A high rate of cross-reactivity has been reported between the specific proteins of hen's egg with proteins of various avian eggs by quantitative immunoelectrophoretic techniques. The aim of this study was to assess the clinical cross-reactivity of different birds' eggs in children with hen's egg allergy based on skin prick test results. MATERIAL AND METHODS: This cross-sectional study enrolled 52 infants with hen's egg allergy and 52 healthy infants with no history of food allergy from October 2018 to April 2019. Skin prick tests were performed in both patient and control groups with fresh extract of white and yolk related to pigeon, duck, goose, turkey, quail, and partridge. RESULTS: Fifty (96.1%) children with hen's egg allergy showed positive sensitization to at least one of the avian eggs. The most frequent positive skin tests were related to quail's white (36 = 69.2%) followed by duck's white (34 = 65.5%), and sensitization was the least frequent in pigeon's yolk (23 = 44.2%). Skin tests of the control group were negative to all the tested extracts. CONCLUSION: Because of fewer sensitizations to some avian eggs, further research should clarify starting oral immunotherapy with the yolk of goose and pigeon in children with hen's egg allergy.

Influence of forkhead box protein 3 polymorphisms (rs2232365, rs3761548) with the outcome of pregnancy: A meta-analysis.

Dysfunction of regulatory T cells (Tregs) may contribute to certain immune-related pregnancy complications. Forkhead box protein 3 (FOXP3) is the key transcription factor of Treg. We performed a systematic review and meta-analysis to evaluate the possible association between FOXP3 polymorphisms -924A/G (rs2232365) and -3279C/A (rs3761548) and immune-related pregnancy complications. After reviewing 78 fully published studies, 10 studies fulfilled previously defined eligibility criteria and were used for meta-analysis. Two single nucleotide polymorphisms showed a significant correlation with increased or reduced risk for immune-related pregnancy complications. For rs3761548, women with allele A were significantly at a higher risk than women carrying allele C (odds ratio = 1.29, 95% confidence interval: 1.20-1.38; p = 0.001). For rs2232365, women with GG or AG genotype were at a higher risk than women with genotype AA, thereby, allele G was significantly associated with a higher risk than allele A. Our meta-analysis supports the notion that immune-related pregnancy complications might be linked to genetic variations in the FOXP3 gene.

Factors affecting length of stay in Children Hospital in Southern Iran.

BACKGROUND: One of the effective indicators for determining the efficiency and optimal use of hospital resources is the length of stay (LOS). This study aimed to determine the patients' length of stay and the factors affecting the LOS in the Children's hospital. METHOD: A cross-sectional study was performed on Children Hospital medical record database including 350 records (April 2015 to Dec 2015). Records were selected by stratified random sampling with proportional allocation. Then the predetermined demographic and hospital variables were extracted through the study of patients' medical records. All statistical analysis were performed using SPSS software. RESULTS: The overall median of the LOS in the studied hospital was 3 days (IQR =3). The results showed that in this hospital the LOS has a significant relationship with the variables of time of admission, the place of residence, type of admission, and the degree of attending physician. Also, with the increasing number of visits, ultrasonography, counseling and laboratory test, LOS was increased. CONCLUSION: Improving processes related to diagnostic procedures, providing adequate staffing for specialized services in all hours of the day, preventing unnecessary and non-emergency admissions in the evening and night, will be effective in optimizing patient LOS.

An overview of diarrheagenic Escherichia coli in Iran: A systematic review and meta-analysis.

BACKGROUND: Diarrheagenic Escherichia coli (DEC) is a common enteric pathogen that causes a wide spectrum of gastrointestinal infections, particularly in developing countries. This is a systematic review and meta-analysis to determine the prevalence of DEC in various geographical regions in Iran. MATERIALS AND METHODS: English (PubMed, Web of Science, Scopus, Embase, Cochrane Library, and Google Scholar) and Persian (IranMedex, SID, Magiran, and Iran Doc) databases were comprehensively searched from January 1990 to April 2017. Study selection and data extraction were performed by two independent reviewers. After assessing heterogeneity among studies, a random effects model was applied to estimate pooled prevalence. Data analyses were done with the Stata software (version 12.0). This meta-analysis was registered with PROSPERO, number CRD42017070411. RESULTS: A total of 73 studies with 18068 isolates were eligible for inclusion within the meta-analysis. The results of random effects model showed that the most prevalent DEC pathotypes were enterotoxigenic E. coli (ETEC) (16%; 95% confidence interval [CI]: 11%-23%), enteroaggregative E. coli (11%; 95% CI: 8%-15%), atypical enteropathogenic E. coli (EPEC) (11%; 95% CI: 8%-14%), Shiga toxin-producing E. coli (9%; 95% CI: 6%-13%), diffuse adherent E. coli (6%; 95% CI: 6%-12%), enteroinvasive E. coli (4%; 95% CI: 2%-6%), and typical EPEC (3%; 95% CI: 1%-5%). CONCLUSION: This study showed that DEC infections in the Iranian population have low frequency. Our data suggest that the ETEC pathotype can be regarded as one of the most important etiological agents of diarrhea in this country. However, the prevalence of DEC pathotypes is diverse in different regions of Iran.

Global status of visceral leishmanial infection among blood donors: A systematic review and meta-analysis.

INTRODUCTION: Transmission of Leishmania through transfusion has been reported from various Visceral leishmaniasis (VL) endemic areas of the world. The true burden of Leishmania infection in blood donors remains generally unknown. Thus, the present systematic review attempted to determine the global prevalence of Leishmania infection among blood donors. METHODS: Data were extracted through five English and five Persian databases during the period from 1997 to 2016. Overall, 16 articles fulfilled the inclusion criteria and were used for data extraction in this systematic review. RESULTS: In total, 13,743 blood donors from different regions of world were examined. The prevalence rate of Leishmania infection according to seropositivity obtained 7% (95%CI: 5%, 8%). The lowest and the highest prevalence were related to Bangladesh 0.25% (95%CI: 0.0%, 1.0%) and Brazil, 16% (95%CI: 12%, 19%). Seroprevalence rate of leishmaniasis among females was more (4.60%) than males. Of 15 studies included in the meta-analysis, the pooled prevalence rate of molecular tests was obtained 2% (95%CI: 1%, 3%) in which Iran and Spain had the lowest and the highest prevalence, 0.05% and 7%, respectively. Our analysis showed that L. infantum was more common than L. donovani as etiological agent of VL among all donors. CONCLUSION: Our data confirms the presence of asymptomatic carriers of VL in endemic areas and supplies as an attentive to the likelihood of these carriers acting as blood donors. Moreover, we conclude that molecular tests for screening in asymptomatic blood donor provide an accurate estimate of the rate of infection over serological tests.

Effects of omega-3 fatty acids on serum levels of T-helper cytokines in children with asthma.

BACKGROUND: There has been a considerable interest in the potential therapeutic value of dietary supplementation with ω-3 fatty acids in patients with asthma. OBJECTIVES: This cross-sectional study was designed to identify the effect of ω-3 fatty acids on symptom score, pulmonary function and serum T-helper cytokine concentrations in children with mild to moderate persistent asthma. METHODS: A total of 39 patients among 50 volunteers completed this 3-month study. They took a soft gel capsule containing 180mg EPA and 120mg DHA daily. Pulmonary function was evaluated in 28 eligible patients by spirometry, and serum levels of Th1, Th2, Th9, Th17 and Th22 cytokines were measured by multiplex cytometric bead assay before and after treatment. RESULTS: After treatment with ω-3, symptom score improved in 28 (72%) patients. The results of spirometry showed remarkable improvement in FEV1/FVC (P=0.044) and PEF (P<0.0001) after treatment, but considering a cut-off of 80%, real improvement was observed in 32% of patients with PEF<80% which raised above the cut-off after ω-3 treatment (P=0.004) whereas, FEV1/FVC changes were above the cut-off value in 89% of the patients. After treatment, IL-17A and TNF-α levels decreased significantly (both P=0.049). CONCLUSION: Oral administration of natural anti-inflammatory products such as ω-3 is a promising complementary approach to managing asthma.

Effect of Ursodeoxycholic Acid on Indirect Hyperbilirubinemia in Neonates Treated With Phototherapy.

BACKGROUND: Hyperbilirubinemia is a common neonatal problem. The present study aimed to investigate the effect of ursodeoxycholic acid in reducing indirect hyperbilirubinemia of infants under phototherapy. METHODS: This double-blind randomized clinical trial was conducted on neonates with jaundice, who had received phototherapy in the hospitals affiliated with the Shiraz University of Medical Sciences in 2013. A total of 80 neonates were enrolled in the study and were randomly divided into 2 groups. The intervention group (n =  0) with indirect hyperbilirubinemia received 10 mg · kg(-1) · day(-1) divided every 12 hours Ursobil (capsule 300 mg) in addition to phototherapy, whereas the control group (n =  0) received only phototherapy. Total bilirubin levels were measured every 12 hours until reaching <10 mg/dL, and then phototherapy was disrupted. The duration of phototherapy was measured. The 2 groups were compared regarding total bilirubin levels at different time points and duration of phototherapy using the generalized estimating equation (GEE) test. RESULTS: The mean of total bilirubin in the intervention group was 12 ± 1.6, 10 ± 1.1, and 9.8 ± 0.2 mg/dL 12, 24, and 48 hours after the beginning of phototherapy, respectively. On the contrary, these measures were 14.4 ± 1.3, 12.5 ± 1.4, and 10.1 ± 1.1 mg/dL in the control group, respectively, (P < 0.05). The mean time required for phototherapy to decrease the bilirubin level to < 10 mg/dL was 15.5 ± 6 and 44.6 ± 13.3 hours in the case and the control group, respectively, (P = 0.001). CONCLUSIONS: Ursodeoxycholic acid had additive effect with phototherapy in neonates with indirect hyperbilirubinemia. This drug also reduced the time period needed for phototherapy and, consequently, decreased the hospitalization period.

Improving the reproductive health literacy of couples on the verge of marriage through the FOCUS-PDCA model: Mixed-method study.

Background & Aims: Education and counseling during marriage is an opportunity to raise some issues needed by couples on the verge of marriage. This study was conducted with the aim of improving reproductive and sexual health literacy of couples on the verge of marriage. Methods: This study was a mixed-methods participatory action research conducted based on the Find, Organize, Clarify, Understand, Select-Plan, Do, Check, Act (FOCUS-PDCA) model in nine steps during 2019-2020 in the city of Bandar Abbas. The Reproductive Health Literacy Scale and the Service Quality (SERVQUAL) Questionnaire were used to evaluate the interventions. Data were analyzed by SPSS version 26. A significance level of less than 0.05 was considered. Results: The mean age of women and men participating in the quantitative part of the study was 21 ± 5 and 25.84 ± 3.9 years, respectively, which was similar to their counterparts in this part of the study, and the difference in the mean scores of reproductive health literacy before and after the changes in the program showed a significant difference (p > 0.001). The study results showed that, except for the understanding dimension, most participants were at an insufficient level in other dimensions of reproductive health literacy. The result of measuring the satisfaction of service recipients indicated good satisfaction in the two dimensions of warranty and accountability, and there was a gap in empathy, assurance, and tangibility dimensions, which the biggest gap was related to the empathy dimension. Conclusion: The changes made in improving the reproductive health literacy of couples were effective, which can be taken into consideration based on the added items in the current program of providing educational services in marriage preparation classes for couples.

Epidemiology of Asthma in Patients with COVID-19: Investigation of Respiratory Allergy as a Risk Factor for COVID-19 Severity.

Background: The outcome of coronavirus disease 2019 (COVID-19) is complicated by various comorbidities; asthma, a common chronic disease, may be considered one of these conditions. This study aimed to investigate the effect of asthma as a potential comorbid condition on the COVID-19 prognosis. Materials and Methods: This retrospective study included all RT-PCR confirmed COVID-19 cases recorded on the Shiraz health department's electronic database from January to May 2020. A questionnaire was designed to collect information about patients' demographics, their history of asthma and other comorbidities, and the severity of COVID-19 by contacting them by phone. Results: Of 3163 COVID-19 patients, 109 (3.4%) had self-reported asthma with a mean age of 42.7 ± 19.1 years. Most patients (98%) had mild-to-moderate asthma, while 2% had severe disease. Among asthmatic patients, fourteen (12.8%) were admitted to the hospital, and five (4.6%) died. Univariate logistic regression results showed that asthma had no significant effect on hospitalization (OR 0.95, 95% CI: 0.54-1.63) and mortality (OR 1.18, 95% CI: 0.48-2.94) in patients with COVID-19. Compared living and deceased patients with COVID-19, the pooled OR was 18.2 (95% CI: 7.3-40.1) for cancer, 13.5 (95% CI: 8.2-22.5) for age 40-70 years, 3.1 (95% CI: 2-4.8) for hypertension, 3.1 (95% CI: 1.8-5.3) for cardiac disease and 2.1 (95% CI: 1.3-3.5) for diabetes mellitus. Conclusion: This study showed that asthma is not associated with an increased risk of hospitalization and mortality in patients with COVID-19. Further studies are needed to investigate the risk of different asthma phenotypes on the severity of COVID-19 disease.

The Safety of Schools Based on Heavy Metal Concentrations in Classrooms' Dust: A Systematic Review and Meta-Analysis.

BACKGROUND: Classroom is where children spend much of their time in; this study aimed to identify the concentration of heavy metals in the classroom dust based on the results of various studies in the world using the published data up to years 2018. METHODS: Fifteen studies were selected for the study according to the inclusion and exclusion criteria. The mean concentration of 11 heavy metals including arsenic, barium, cadmium, cobalt, chromium, copper, iron, lead, manganese, nickel, and zinc was extracted. RESULTS: The highest mean concentration of heavy metal (mg/kg) in classroom dust was related to iron (3904.7, 95%CI: 3657.1-8154.3), zinc (429.9, 95%CI: 182.8-677.1) and barium (419.2, 95%CI: 274.7-253.7), respectively. Subgroup analysis showed the maximum concentration (mg/kg) of iron in Iran (16945.5), zinc in Hong Kong (2293.5), barium in China (979.8), manganese in Iran (288.9), lead in Iran (258.8), chromium in Ghana (381.3), copper in Hong Kong (274.4), nickel in Iran (50.1), cobalt in China(43.4), arsenic in China(13.7) and cadmium in Hong Kong(8.7). CONCLUSION: Even safe and healthy classrooms can threaten children's health by heavy metals. These metals are important since they are naturally found throughout the earth's crust, accumulate in the food chain and contaminate drinking water as well as alloys in school equipment.

Association of IL-1Ra Ser133Ser Variant with Susceptibility to Immune-Mediated and Inflammatory Diseases: A Meta-Analysis of 2622 Cases and 3854 Controls.

BACKGROUND: The rs315952 (Ser133Ser) has been reported to influence the risk for immune-mediated as well as inflammatory diseases in many studies; however, the results remain inconsistent. The current meta-analysis was performed to give a more precise estimation for the relationship between this IL-1Ra missense variant and the risk of both types of diseases. METHODS: Relevant publications were retrieved through a literature search in Web of Science, Medline, PubMed, Scopus, EMBASE, and Google scholar search engines, between 2000 and 2019. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of the association. RESULTS: Twenty-two studies, including 2622 cases with and 3854 controls were identified. The IL-1Ra Ser133Ser variant does not confer an increased overall risk for immune-mediated and inflammatory diseases. This variant was statistically associated with decreased risk of systemic lupus erythematosus (under allelic, codominant heterozygous, and dominant models) or ankylosing spondylitis (in allelic and recessive models)(OR<1). Moreover, alleles, as well as genotypes of the IL-1Ra Ser133Ser variant, may confer an increased risk of immune-mediated and inflammatory diseases in Hispanics. However, this variant was not associated with susceptibility to immune-mediated and inflammatory diseases in both Asians and Arabs. CONCLUSION: The pooled results fail to support the hypothesis that the IL-1Ra Ser133Ser variant is associated with the overall risk of immune-mediated and inflammatory diseases. Performing large scale replication and meta-analysis of functional variants within this gene is encouraged to further investigate the influence of IL-1Ra SNPs on overall disease susceptibility.

Geo-climatic factors in a newly emerging focus of zoonotic visceral leishmaniasis in rural areas of north-eastern Iran.

Visceral leishmaniasis (VL) is the fatal form of leishmaniasis. A newly emerging focus of zoonotic VL (ZVL) including 13 villages has been reported from Maraveh Tappeh County, Golestan province, north-eastern Iran. We investigated the effect of climatic and environmental factors on the occurrence of disease in this focus by geographical information systems (GIS) approaches and logistic regression models. The incidence rate of ZVL in human and dog population was estimated 1.2% and 27.3%, respectively, in the studied areas. Rock soil type (OR = 11.7), rainfall (OR = 1.04) and elevation (OR = 0.99) were found as determinants of ZVL. Also, almost all infected villages were in close proximity of rivers. Cavities of rock soil around rivers are assumed as suitable areas for sandfly resting and growth by providing shadow and moisture. Rainfall also provides appropriate moisture in semi-arid regions for survival of sandflies. The negative effect of higher altitude can be explained by some sandfly life-limiting conditions like freezing weather. Accordingly, regions with lower altitude and higher rainfall, covered by rock and in close proximity of rivers, are the hazard zones for ZVL in the Maraveh Tappeh. Air humidity, temperature, land cover type and slope were not predictors of disease in the current study. Further investigations on human population movement, probable reservoirs and vectors of disease can provide valuable data for modelling the future distribution of ZVL in the Iranian province.

Evolutionary puzzle of Toxoplasma gondii with suicidal ideation and suicide attempts: An updated systematic review and meta-analysis.

The World Health Organization has reported an annual global suicide rate of 14.5 per 100,000 people. On the other hand, it is estimated that approximately one-third of the global population are infected with Toxoplasma gondii (T. gondii) parasite. It is widely assumed that microbial pathogens, such as T. gondii, are probably associated with affective and behavioural modulation. The present article aimed to assess the proposed role of toxoplasmosis in raising the risk of suicidal ideation (SI) and suicide attempts (SA) using the available epidemiological data. Seven major electronic databases and the Internet search engine Google were searched for all the studies published between the 1st of January 1950 and 31st of October 2019. The heterogeneity and the risk of bias within and across studies were assessed. Following data extraction, pooled odds ratios (ORs) with 95% confidence interval (CI) across studies were calculated using the random-effects models. A total number of 9,696 articles were screened and 27 studies were regarded as eligible in our systematic review (SI with five papers and 22 papers on SA). A significant association was detected between antibodies against T. gondii with TA (ORs = 1.57; 95% confidence interval [CI] 1.23-2.00, p = .000). Exploration of the association between T. gondii and SA yielded a positive effect of seropositivity for IgG antibodies but not IgM. Despite the limited number of studies, a statistical association was detected between suicidal behaviours and infection with latent T. gondii.

Repurposing azole antifungals into antileishmanials: Novel 3-triazolylflavanones with promising in vitro antileishmanial activity against Leishmania major.

Previously, we have described a series of azole antifungals namely 3-(1,2,4-triazol-1-yl)flavanones (TFs) containing an N-(phenethyl)azole framework required for sterol 14α-demethylase (CYP51) inhibitory activity. Similar mechanism of action of azoles in fungi and protozoan parasites prompted us to investigate the potential effects of TFs against promastigote and amastigote forms of Leishmania major (L. major), as well as their toxicity against macrophages, apoptosis induction and in silico interactions with the target enzyme. All compounds showed more potent anti-parasitic activity against L. major in comparison with reference azole drug fluconazole and standard antileishmanial agent glucantime. Among the tested compounds, the 4-chloro derivative (TF-2) was found to be the most potent one, being about 13 times more potent than fluconazole against promastigotes. TF-2 decreased both mean infection rate of macrophages (MIR) and mean number of amastigotes per macrophages (MNAPM), significantly more than fluconazole (P < .001). Furthermore, the cytotoxicity assay against J774.A.1 macrophages revealed that this compound displays high selectivity against amastigotes over macrophages (SI = 30.21). The in silico study showed that TF-2 can properly accommodated in the active site of parasitic CYP51 and coordinated to the heme. The SAR analysis showed that the introduction of 4-chloro on 2-phenyl moiety results in the best profile of activity and selectivity. Accordingly, the compound TF-2 prototype can be considered as promising candidate for development of new antileishmanial agents.

Status of Linguatula serrata infection in livestock: A systematic review with meta-analysis in Iran.

OBJECTIVES: The present systematic review attempted to determine the prevalence of Linguatula serrata (L. serrata) infection among Iranian livestock. The L. serrata known as tongue worm belongs to the phylum pentastomida and lives in upper respiratory system and nasal airways of carnivores. Herbivores and other ruminants are intermediate hosts. METHODS: MEDLINE, Embase, Web of Science, Google Scholar, and the Cochrane Library were searched from Nov 1996 to 22 Apr 2019 by searching terms including "Linguatula serrata", "linguatulosis", "pentastomida", "bovine", "cattle", "cow", "buffalo", "sheep", "ovine", "goat", "camel", "Iran", and "prevalence" alone or in combination. The search was conducted in Persian databases of Magiran, Iran doc, Barakatkns (Iran medex) and Scientific Information Database (SID) with the same keywords. After reviewing the full texts of 133 published studies, 50 studies had the eligibility criteria to enter our review. RESULTS: By random effects model analysis, the pooled prevalence of linguatulosis was 25% (95%CI: 18.0-33.0, I 2 = 98.67 % , P < 0.001) in goats; 15.0% (95%CI: 10.0-20.0, I 2 = 97.95 % , P < 0.001) in sheep; 12.0% (95%CI: 7.0-18.0, I 2 = 98.05 % , P < 0.001) in cattle; 7% (95%CI: 2.0-16.0, I 2 = 97.52%) in buffalos and 11.0% (95%CI: 6.0-16.0%, I 2 = 96.26 % , P < 0.001) in camels. The overall prevalence in livestock was estimated to be 25%. The highest infection rate was recorded in West Azerbaijan Province (68%) and the lowest rate was in Khuzestan Province (0.23%) (P < 0.05). CONCLUSIONS: We concluded that the high prevalence of L. serrata infection in livestock (mainly ovine linguatulosis) show the endemic status of linguatulosis in several parts of Iran and will pose a risk for inhabitants. Control strategies to reduce the parasite burden among these animals are needed.